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11 Important things to keep in mind before buying a Health Insurance plan in 2025
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There are many significant things that a policy seeker has to consider while buying a health insurance policy. Let us discuss 11 such key things that you must keep in mind at the time of buying a health insurance plan.
Despite its importance, the penetration of health insurance is still very less in India as compared to many other countries. Most people in the country depend on the health cover offered as part of their employment by their organizations/employees. There is a very miniscule percentage of people who actually buy health insurance using money from their own pocket to cover them and their families against diseases. Most people shun health insurance on the pretext that they are costly and they would have to pay the premium every year even if they do not use the coverage. Further, many people avoid buying health plans because of lack of awareness and the process being complex. There is another category of people who avoid health insurance plans because they cannot trust the health insurance company and their promises made regarding the health coverage.
Health insurance is essential for financial security during medical emergencies. With rising healthcare costs, choosing the right health insurance policy is more important than ever. If you're planning to buy health insurance in 2025, here are 11 key things to consider before making your decision.
1. Coverage Amount (Sum Insured)
Choose a policy with sufficient coverage to handle medical expenses, including hospitalization, surgeries, and critical illnesses. A higher sum insured is beneficial, especially in metro cities where healthcare costs are high.
2. Type of Health Insurance Plan
There are different types of health insurance plans, such as:
- Individual Health Insurance
- Family Floater Plan (for the entire family)
- Senior Citizen Health Insurance
- Critical Illness Insurance (for serious diseases like cancer or heart disease)
- Group Health Insurance (offered by employers)
- Select a plan that suits your needs and budget.
3. Cashless Hospitalization
Check if the insurance company offers a cashless treatment facility at network hospitals. This allows you to get treated without paying upfront, as the insurer settles the bill directly with the hospital.
4. Waiting Period for Pre-Existing Diseases
If you have existing health conditions (like diabetes, hypertension, or thyroid issues), check the waiting period before your coverage starts. Some policies have a waiting period of 2–4 years for pre-existing diseases.
5. Claim Settlement Ratio (CSR)
The claim settlement ratio indicates the percentage of claims an insurance company settles. A high CSR (above 90%) means the company is more reliable in paying claims on time.
6. Inclusions and Exclusions
Read the policy details carefully to understand:
- What is covered (hospitalization, surgeries, OPD expenses, maternity benefits, etc.)
- What is not covered (certain diseases, cosmetic treatments, waiting period exclusions, etc.)
7. Premium and Affordability
Choose a policy that offers good coverage at an affordable premium. Compare different plans online and use premium calculators to find the best deal.
8. Co-Payment and Deductibles
Some policies have a co-payment clause, which means you need to pay a part of the bill from your pocket. Check if your plan has co-payment or deductibles and how they affect your claim.
9. Lifetime Renewability
Opt for a policy that offers lifetime renewability so you can stay covered even in old age without worrying about policy expiration.
10. No-Claim Bonus (NCB)
If you don’t make any claims in a year, many insurers offer a No-Claim Bonus (NCB), which increases your sum insured without raising the premium.
11. Additional Benefits (Add-Ons)
Some insurance policies offer additional benefits like:
- Maternity Cover (for pregnancy-related expenses)
- OPD Cover (for doctor visits and medicines)
- Critical Illness Rider (for diseases like cancer, stroke, or kidney failure)
- Room Rent Capping Removal (so you can choose any hospital room without limits)
Things to keep in mind before buying a Health Insurance policy in 2025 India
In simple language, the insurance cover purchased to protect against the expenses of healthcare/medical costs is known as health insurance.
Here are the things to consider before buying health insurance:
Type of coverage
Types of Policy
Sum assured
Network hospitals
Waiting period
Pre-existing diseases etc.
HDFC ERGO Health Insurance
Star Health Health Insurance
Niva Bupa Health Insurance
ICICI Lombard Health Insurance
Care Health Insurance
Manipal Cigna Health Insurance
Bajaj Allianz Health Insurance etc.
Health insurance policies are very important, especially due to the rising medical costs in India. However, you may note that health insurance plans are generally valid for one year, and need to be renewed annually.
Author Bio
Paybima Team
Paybima is an Indian insurance aggregator on a mission to make insurance simple for people. Paybima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 17 years of experience. Paybima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.
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